Final Q4 Review Flashcards
When bowel prolapses into the distal bowel and is propelled in an ante grade fashion, this condition is known as:
Intussusception
Hypertrophic pyloric stenosis most commonly occurs most commonly occurs in:
Males, between 2-6 weeks, bile free projectile vomiting
In patients with appendicitis, the outer diameter should measure at greater than ___mm
7mm
Findings that may indicate appendicitis includes:
- free peritoneal fluid
- loculated fluid in lower abdomen
- appendicoloth
Children with intussusception exhibit:
- colicky abdominal pain
- vomiting
- bloody stools
The length of the pediatric gallbladder should not exceed
The length of the kidney
An abdominal ultrasound may be ordered in the neonate when jaundice persists beyond:
2 weeks
The most common causes of prolonged neonatal jaundice include:
Biliary atresia, hepatitis, choledochal cysts
The most common type of choledochal cyst is
Fusiform dilation of CBD
Infantile for of hepatocellular carcinoma
Hepatoblastoma
The pylorus muscle connects the _____ with the duodenum
Antrum of the stomach
The most common acute abdominal disorder in early childhood
Intussusception
Condition may occur when fetus is stressed during a difficult delivery or during a hypoxia insult
Adrenal hemorrhage
Thin structure in neonate with echogenicity similar to or slightly greater than the normal liver parenchyma
Renal cortex
Most common cause of renal cystic disease in the neonate
MCDK
This structure should not be mistaken for dilated calyces or cysts in the infant?
Medullary pyramids
If the ipsilateral renal is absent or ectopic in location, the adrenal gland:
Remains in the renal fossa
Genitourinary problem commonly is commonly associated with prune belly syndrome
Uteral reflux
Neuroblastoma is typically a malignant tumor of the
Adrenal gland
The most common cause of bladder outlet obstruction in the male neonate is
PUV
The normal renal length in the pediatric patient varies with ____
Age
The left adrenal gland extends _____ to the kidney
Medially
The adrenal medulla in the neonate appears as an
Echogenic stripe
Obstruction that demonstrates a pelvocaliceal dilation without ureteral dilation
UPJ
Bilateral renal enlargement is seen with which condition
ARPKD
Peak age range for Wilms tumor
2-5 years
What 3 mechanisms account for development of hydrocephalus?
Outflow obstruction
Decreased absorption
Overprotection of CSF
Sonography of the neonatal brain is initially evaluated through the:
Anterior fontanelle
What structure produces 40% of the CSF
Choroid plexus
Convolutions on the surface of the brain are called
Gyri
The most common cause of congenital hydrocephalus is
Aqueductal stenosis
most likely the result of a germinal matrix hemorrhage
Subependymal cyst
The hip bones:
Ilium, ischium, pubis
Bending of hip backwards:
Extension
The articulation of the head of the femur with the acetabulum of the hip bone forms the
Hip joint
Indications for sonography of the neonatal hip
Rule out hip dysplasia
Breech birth
Abnormal hip examination
Sonographic examination of the infant hip is performed with a _____ transducer
Linear array
In the _______ maneuver, down and outward pressure is applied with the patient lying in a supine position with the hip adducted and flexed 90 degrees
Barlow
Moving sideways outward
Abduction
The physical signs of the development of a displacement of the hip
- extreme abduction
- shortening of femur
- asymmetric skin folds
Sonography is able to image the spinal cord because
Ossification of the posterior spinal elements is incomplete
Pathological fixation of the spinal cord in an abnormal caudal location is known as
Tethered cord
Indications for spinal sonography;
- back mass
- midline cutaneous deformities
- large collection of hair on the back
How many lumbar vertebrae are in the vertebral column
5
Typical signs of biliary atresia
- distended abdomen
- persistent jaundice
- dark urine
The presence of ______ is associated with biliary atresia
Polysplenia
Most common benign pediatric liver tumor is
Hemangioendothelioma
2nd most common malignant tumor in childhood
Hepatocellular carcinoma
Pediatric condition associated with the palpable “olive mass”
Hypertrophic Pyloric Stenosis
Individual pyloric muscle wall thickness of ___ or greater indicates pyloric stenosis
Greater than 3mm
The _____ is a long, tubular structure, which connects the dome of the bladder to the umbilicus
Urachus
Sonographic findings of a unilateral mass represents a “cluster of grapes” with no identifiable renal pelvis suggests
MCDK
Most common renal tumor of neonate
Mesoblastic nephroma
Most common disorder of neonatal brain is
Hydrocephalus/ventriculomegaly
Maneuver that requires neonatal hip to be flexed 90 degrees and thigh to be abducted
Ortolani
The _____ forms the bony spine, meninges, and muscle
Mesoderm
There are ____ cervical vertebrae
7
Middle layer of spinal cord
Arachnoid mater
Patient position for neonatal spine exam
Supine
Right hepatic lobe shouldn’t extend more than ____ below the costal margins in an infant
1cm
CBD should measure less than ____ in neonates and less than ____ in adults
1mm , 7mm
In infants the gallbladder should measure:
1.5cm-3cm
The sonographic findings of hypertrophic pyloric stenosis will demonstrate a channel length of _____ or greater
15mm
Neonatal hepatitis may reach the liver from:
Placenta, vagina, catheters
Acholic stools is a clinical sign of
Biliary atresia
Hypoplastic remnant of a biliary stucture appears as a small triangular structure seen anterior to the porta hepatis with this condition
Biliary atresia
Serum alpha fetoprotein will _____ with an adenoma of liver
Remain unchanged
Hepatoblastoma is associated with why syndrome?
Beckwith-widemann syndrome
Differential diagnosis or appendicitis
Intussusception
Ovarian torsion
Ovarian cyst
Reasons for non-visualization of the appendix:
Overlying bowel
Retrocecal position
Overdistended urinary bladder
Inflammed appendix is compressible/noncompressible
Noncompressible
Peristalsis is normally “not/is” seen in the appendix
Not
Sandwich sign appearance describes what condition
Intussusception
Which gastric bezoar is made up of vegetable matter
Phytobezoar
Which gastric bezoar is made up of hair balls
Trichobezoar
Urine refluxes into the ureter and kidney with severe swelling and twisting of the ureter in which grade of VUR?
Grade 5
Urine refluxes into the ureter and kidney with no swelling indicates which grade of VUR?
Grade 2
Results from an ectopic bladder insertion and cystic dilation of the distal ureter of a completely duplicated renal collecting system:
Ureterocele
85% of patients with prune belly syndrome have an associated:
VUR
Renal cysts are associated with what two conditions?
Tuberous sclerosis
Von Hillel-Lindau
Grooves or depressions in the brain are called
Sulci/sulcus
The fissure that separates the two cerebral hemispheres is
Interhemispheric fissure
During which study/plane is it critical to obtain symmetrical images of the brain?
Coronal
Which classification of intraventricular hemorrhage corresponds with minimal venticular enlargement:
Grade 2
Which classification of intraventricular hemorrhage corresponds with moderate ventricular enlargement
Grade 3
Germinal matrix intraventricular hemorrhage lesions affect what percent of infants less than 34 weeks gestation
40-70%
The ____ hip is most often affected by DDH
Left
The outer layer of the spinal cord
Dura mater
The spinal cord should terminate at which level
L3
The horse tail appearance of the spine refers to which anatomical location
Cauda equina
Nerve roots appear ______ and the spinal cord appears ________ sonographically
Echogenic
Hypoechoic
A dimple like opening in the midline of the spine connecting deep into the spinal cord is:
Dermal sinus tract
The functional portion of the breast consists of ______ lobes
15-20
Forms a fibrous skeleton that is responsible for maintaining the shape of the breast
Coopers ligaments
As a woman ages, the glandular breast tissue is replaced with:
Fat
Coopers ligaments are best characterized as
Echogenic line interfaces in all breast layers
The retromammary layer sonographical appearance:
Hypoechoic
The most important signs to look for in determining a cystic lesion of the breast include
Well defined borders
Good through transmission
Anechoic
Clinical findings of lumpy, painful, tender breasts that vary with monthly cycles usually represent
Fibrocystic disease
Most common solid benign tumor of the breast
Fibroadenoma
Sonographic characteristic of a fibroadenoma
Uniform, low-level homogeneous echoes
Lymphatic drainage from all parts of the breast generally flows to the ___ lymph nodes
Axillary
The most common malignant neoplasm of the breast
Invasive ductal carcinoma
Characteristic findings of breast carcinoma
Taller than wide mass
Noncompressible
irregular margins
heterogeneous low level internal echo patterns with calcifications
Skin dimpling may be caused by ______ of tissue caused by _____
Retraction of tissue secondary to tumor infiltration
The most common clinical sign of breast carcinoma is
Palpable lump
Primary purpose of breast screening exam is
Provide for early detection of breast carcinoma
The mid portion of the right medial and left lateral breast would be annotated as which clock position?
3
A normal extension of breast tissue into the axillary region is called
Tail of Spence
Artery responsible for supplying blood to more than half of the breast
Internal mammary
Benign pathology that often occurs during lactation and causes red and tender breasts
Acute mastisis
The thyroid gland consists of ____ lobes
2
The lobes of the thyroid gland are connected by the
Isthmus
All of the following structures form neighboring structures for the thyroid gland except the:
Longest colli muscle
Strap muscles
Sternocleidomastoid muscle
Parotid muscle
Parotid muscle
The pyramid of Lobov the thyroid gland extends from the
Superior isthmus
Structure that lies medial to the left thyroid lobe
Esophagus
The most common cause of thyroid disorders worldwide is
Iodine deficiency
Decreased levels of T3 and T4 and increased levels of TSH should indicate
Hashimoto’s thyroiditis
Most common sonographic feature of a thyroid adenoma
Hypoechoic peripheral halo
The parathyroid glands produce a hormone that affects the
Kidneys, bones and gastrointestinal tract
The normal parathyroid glands are located on the ______ and the _______ surface of the thyroid gland
Posterior, medial
Usually ______ parathyroid glands exist
4
A solitary thyroid nodule in the presence of ipsilateral lymphadenopathy suggests
Follicular carcinoma
The most common cause of primary hyperparathyroidism is
Parathyroid adenoma(PTA)
A palpable anterior midline mass between the hyoid bone and the isthmus
Thyroglossal duct cyst
The longus coli muscle lies ______ to the thyroid gland
Posterolateral
Hyper function of all parathyroid glands with no apparent cause occurs with:
Primary hyperplasia of the parathyroid glands
Increased vascularity with color Doppler termed the thyroid inferno is observed in
Graves’ disease
The most common thyroid malignancy
Papillary carcinoma
And abnormal lymph node demonstrates _____ shape/contour
Round
A cystic formation located lateral to the thyroid gland in the neck, in the submandibular region is:
Branchial cleft cyst
The risk of malignancy ________ with the presence of multiple thyroid nodules
Decreases
The esophagus lies _____ to the left lobe of the thyroid
Medial
The internal jugular vein lies _____ to the common carotid
Medial
Which muscle lies posterior to the thyroid gland
Longus coli
T3 and T4 amounts are elevated while TSH levels are decreased in:
Hyperthyroidism
Chronic renal failure is associated with(thyroid):
Secondary hyperparathyroidism
Which two lab values are elevated in patients with primary hyperparathyroidism
PTH and serum calcium
The diameter of a varicocele measures more than ____ mm
2mm
the testes are covered by a fibrous capsule formed by the:
tunica albuginea
the body of the epididymis coures ______ to the testis
superior and posterolaterally
linear stripe of variable thickness and echogenicity running through the testis in a craniocaudal direction represents:
mediastinum testis
an undescended testis is always found in the inguinal canal: T/F
false
most common cause of acute scrotal pain in adolescents
torsion
varicoceles are common on the ____ side
left
a spermatocele is always located:
epididymis head
almost always transpire secondary to epididymitis:
orchitis
clinical history of vasectomy is associated with:
sperm granulomas
primary source of blood flow to the testicles is via the ______ arteries
testicular
a hydrocele develops between:
parietal and visceral layers of tunica vaginalis
compared with the testis, the epididymis typically appears:
hypoechoic
the rete testis is located in the _____ of the testis
hilum
microlithiasis of the testis is associated with a:
malignant neoplasm
tubular ectasia of the rete testis is associated with:
epididymal cyst
intratesticular cysts have an association with
spermatoceles
venous drainage of the scrotum occurs through the veins of the:
pampiniform plexus
the right testicular vein drains into the
IVC
acute hematoceles appear
echogenic
over time, hematoceles show
low level/linear, cystic
sonographic findings of epididymo-orchitis:
enlarged, hypoechoic epididymis and testis
______ occurs when the tunica vaginalis completely surrounds the testis, epididymis, distal spermatic cord, allowing them to move and rotate freely within the scrotum
bell clapper deformity
the _____ lines the inner walls of the scrotum, covering each testis and epididymis
tunica vaginalis
color doppler will confirm ______ vascularity which epididymo-orchitis
increased
occurs when pus fills the space between the layers of the tunica vaginalis and usually contains septations or debris
pyocele
if surgery is performed within 5-6 hours after the oset of pain in a patient with testicular torsion, what percentage can be saved
80-100%
most scrotal cysts are intratesticular: T/F
false
Associated with infertility
varicocele
most common cause of painless scrotal swelling
hydrocele
which prostate zone is benign prostatic hyperplasia usually found
transitional
which column of tissue is located on the ventral/anterior aspect of the penis
corpus spongiosum
a painful erection lasting more than 4 hours:
priaprism
which prostate zone is the location of most prostate cancers
peripheral
fibrotic thickening of the tunica albuginea seen in Peyronie’s disease appears:
linear, echogenic & calcified with shadowing
the ___ of the prostate is the superior portion
base
which lab value is typically elevated in prostate cancer?
PSA(prostate specific antigen)
a bursa provides what function:
fluid protection to areas subject to friction
the crass position is used to evaluate:
shoulder
imaging artifact that depends on the angle of incidence
ansiotropy
infringement of the median nerve in the wrist:
carpel tunnel
pennate pattern in which fibers converge to a central tendon
circumpennate
band-like structure, flat tendon, connecting muscle to bone
aponeurosis
the achilles tendon is at an increased risk for injury because:
its limited blood supply
proximal portion of the muscle is considered:
origin
the posterior glenoid labrum is a good landmark to help locate:
infraspinatus tendon
appear sonographically as alternating hyperechoic and hypoechoic parallel lines connecting muscle to bone
tendons
nerves appear more _____ than tendons
hypoechoic
nerves appear more _____ than muscles
hyperechoic
common communicating bursa that is seen in the medial popliteal fossa:
bakers cyst
artifact that occurs due to sound bouncing between two closely placed reflectors within a structure:
comet tail
pain over the thumb side of the wrist is termed:
de quervians tendonitis
the first branch of the aortic arch splits into the right eca and right ica: T/F
false
the common carotid artery splits into the _______ and ________ arteries
internal and external
the right and left vertebral arteries travel cephalad to form the ____ artery
basilar
typically located in the scalp or neck
superficial epidermal cyst/sebaceous cyst
the two skin layers are distinguishable sonographically: T/F
false
composed of vascular channels are appears hypoechoic
hemangioma
most common tumor of the hand and wrist
ganglion cyst
